In our U.S. Pat. No. 6,027,531 a description is made of a new concept of intraocular lens, implantable in the eye to replace the natural crystalline lens. This IOL is inserted in a calibrated, circular and continuous anterior and posterior capsulorhexis, of which the diameters are slightly smaller than the optical diameter of the lens in order to fit tightly in the groove defined at the periphery of the optical part by two flanges (one flange is the continuation of the anterior part of the optic and the other flange is the continuation of the posterior part of the optic). The perpendicularly oriented axes of the flanges facilitates the insertion of both anterior and posterior capsule into the groove by the surgeon and stabilize and avoid tilting of the IOL.
The IOL as described in U.S. Pat. No. 6,027,531 is being manufactured by the company Morcher, Germany. The intraocular lens has been implanted in children (7 months of age to 15 years), in young adults (16 to 21 years) and in about 200 adult eyes at this moment with a follow-up period of at least 5 years. The results of the clinical work and experience have been published and those publications are herewith incorporated by reference:                Tassignon M. J., De Groot V., Vrensen G. F. J. M. (2002). Bag-in-the-lens implantation of intraocular lenses. J. Cataract Refract. Surg. 28 (7), 1182-1188        De Groot V., Tassignon M. J., Vrensen G. F. J. M. (2005). Effect of bag-in-the-lens implantation on posterior capsule opacification in human donor eyes and rabbit eyes. J. Cataract Refract. Surg. 31 (2), 398-405        
These publications corroborate our hypothesis as stated in the U.S. Pat. No. 6,027,531 that secondary cataract is avoided in 100% of the cases. Secondary cataract is the most frequent complication corresponding to posterior capsule opacification (PCO) in eyes operated with the traditional lens-in-the-bag implantation technique.
Besides the long-lasting excellent optical results of 100% transparency and besides the excellent stability of the lens within the eye, the bag-in-the-lens presents the additional option to be positioned electively within the eye by the surgeon. The idea of elective positioning or centration according to a visual axis of the eye of an intraocular lens, has not yet been described.
Since the publication of the U.S. Pat. No. 6,027,531, other authors have used the idea to fixate the IOL using the posterior capsule (Okada Kiyashi, U.S. Pat. No. 6,881,225), but the design is very complicated and the implantation is based on the lens-in-the-bag technique having the permanent risk that lens epithelial cells will encapsulate the IOL with proliferative tissue.
Furthermore, a large number of proposals have been made to correct the eye optics for far and for near at the time of cataract surgery. A binocular lens system was proposed by Robert Steinert (U.S. Pat. No. 6,537,317) and Lang Alan (U.S. Pat. No. 6,576,012), aiming at allowing far and near vision simultaneously. However, these IOLs are composed of two optic portions that still have the risk of cellular deposits and proliferation between the parts.
Additionally, in order to correct the optical aberrations of the eye Theodore Werblin (U.S. Pat. No. 6,413,276) proposed a three-part IOL of which at least one part can be removed and adapted according to the ocular aberrations and repositioned in a second surgical step. This elaborated IOL also has the risk of cellular deposits at the level of the interfaces causing visual impairment with over time.